胆囊床烧灼术的胆囊切除术可能足以治疗胆囊T1bN0M0神经内分泌癌：病例报告及文献综述
Cholecystectomy with gallbladder bed cautery might be sufficient for T1bN0M0 neuroendocrine carcinoma of gallbladders: Cases report and literature review.
作者信息
Liu Wei, Chen Weijie, He Xiaodong, Qu Qiang, Hong Tao, Li Binglu
机构信息
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China.
出版信息
Medicine (Baltimore). 2017 Nov;96(47):e8778. doi: 10.1097/MD.0000000000008778.
INTRODUCTION
Neuroendocrine carcinoma was a rare kind tumor in gallbladders. So far, there is no consensus of treatment of the gallbladder neuroendocrine carcinoma.
CASE PRESENTATION
Three patients, 1 male and 2 females, were admitted in our hospital because of right upper quadrant pain. No one complained fever, jaundice, weight loss, or carcinoid syndrome-related symptoms such as diarrhea, flushing, edema, and wheezing. The MRI detected the broad base of gallbladder tumors. However, they refused any radical surgery. We performed a laparoscopic cholecystectomy with gallbladder bed cautery. The pathology results showed that 2 cases were mixed neuroendocrine carcinoma (NECs), and 1 case was a simple NEC. Chromogranin A and synaptophysin were positive in all cases. The pathological TNM stages of all patients were in the T1bN0M0 stage. The range of Ki-67 was from 40% to 80%. During the at least 26 months' follow-up, there is no case with the recurrence of the carcinoma without any chemotherapy or radiotherapy.
CONCLUSIONS
Cholecystectomy with gallbladder bed cautery might be enough for treatment of T1bN0M0 gallbladder neuroendocrine carcinoma.
引言
神经内分泌癌是胆囊中一种罕见的肿瘤。到目前为止，胆囊神经内分泌癌的治疗尚无共识。
病例报告
三名患者，1名男性和2名女性，因右上腹疼痛入住我院。无人主诉发热、黄疸、体重减轻或类癌综合征相关症状，如腹泻、潮红、水肿和喘息。MRI检测到胆囊肿瘤基底较宽。然而，他们拒绝任何根治性手术。我们进行了腹腔镜胆囊切除术并烧灼胆囊床。病理结果显示，2例为混合性神经内分泌癌（NEC），1例为单纯性NEC。所有病例嗜铬粒蛋白A和突触素均为阳性。所有患者的病理TNM分期均为T1bN0M0期。Ki-67范围为40%至80%。在至少26个月的随访期间，无一例患者在未进行任何化疗或放疗的情况下出现癌症复发。
结论
胆囊床烧灼的胆囊切除术可能足以治疗T1bN0M0期胆囊神经内分泌癌。
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